Clin Orthop Surg.  2012 Jun;4(2):163-166. 10.4055/cios.2012.4.2.163.

Augmentation with Transcortical Wiring of an Onlay-type Prosthesis for a Deficient Patella during Revision Total Knee Arthroplasty

• Seo JG
• Moon YW
• Lim SJ
• Lim JS
• Kim SM

• KMID: 1383879
• DOI: http://doi.org/10.4055/cios.2012.4.2.163

Abstract

The management of patellae with a severe bony deficiency during revision total knee arthroplasty is a challenging problem. However, using a technique of augmentation with transcortical wiring of an onlay-type prosthesis allowed the authors to revise a deficient patellae successfully. After making the decision to revise the existing patellar component, the procedure was found to be technically straightforward. Furthermore, the procedure does not require sophisticated instruments, only an onlay-type prosthesis, cement and wires. This technique entails fixing wires to the three pegs of the patellar component, passing the wires through drill holes in the anterior cortex and, after compression of a cemented prosthesis, augmenting the fixation by twisting the wires anteriorly. We believe that stable fixation and painless articulation will be obtained with the described technique for deficient patellae.

Keyword

Patella; Revision total knee arthroplasty; Augmentation; Transcortical wiring

MeSH Terms

Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee/*methods
Bone Cements
*Bone Wires
Humans
Knee Prosthesis
Middle Aged
Patella/*surgery
Prosthesis Design
Prosthesis Implantation/*methods

Figure

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  Fig. 1 Wires are wound around each peg.

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  Fig. 2 (A) Wires are passed from the undersurface of the patella to the outer surface through the bone holes. (B) The space between the bone bed and the patellar component is filled with cement.

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  Fig. 3 (A) Enough tension is applied to the three wires placed on the outer surface using wire holders. (B) The wires are then twisted immediately above the cortex.

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  Fig. 4 Lateral view of the knee was taken immediately after surgery.

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  Fig. 5 Tangential view of the patella was taken 2 months after surgery.

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